Dosimetric Evaluation of ISBT for Tongue Cancer

Under institutional review board approval, 30 patients with tongue cancer treated with ISBT between September 2018 and August 2021 were evaluated. Planning target volume (PTV) was defined as the same as gross tumor volume (GTV). The mean ± standard deviation (SD) of the PTV was 11.7 ± 7.9 cm³ (range, 2.7–28.6 cm³). Needles were inserted under the jaw into the oral cavity and replaced with flexible plastic catheters. The number of applicators used was 5.9 ± 2.4 (range, 3–14). All patients were treated with a spacer made of resin inserted between the mandible and tongue. A 3-mm-thick LB was inserted into the spacer (Fig. 1). Details of the spacer with the lead block are described elsewhere [7 (link)]. The LB was removed during image acquisition of the planning CT to avoid the effects of metal artifacts. The Oncentra Brachy (Elekta, Stockholm, Sweden) TPS was used for treatment planning. The prescribed dose was 54 Gy/9 fractions/5 days [14 (link)]. Graphical optimization was used to improve PTV coverage and reduce the mandibular dose.Fig. 1

Photographs of the spacer containing the lead block

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Akino Y., Shiomi H., Tsujimoto T., Hamatani N., Hirata T., Oda M., Takeshita A., Shimamoto H., Ogawa K, & Murakami S. (2023). Inverse planning optimization with lead block effectively suppresses dose to the mandible in high-dose-rate brachytherapy for tongue cancer. Japanese Journal of Radiology, 41(11), 1290-1297.

Publication 2023

Oncentra Brachy

Catheters Institutional review board Mandibular Metal Needles Oral cavity Patients Resin Tongue Tongue cancer

Corresponding Organization : Osaka University

Other organizations : Osaka University Hospital

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Variable analysis

independent variables

Insertion of flexible plastic catheters under the jaw into the oral cavity
Use of a spacer made of resin inserted between the mandible and tongue
Insertion of a 3-mm-thick lead block (LB) into the spacer

dependent variables

Planning target volume (PTV)
Number of applicators used

control variables

Patients with tongue cancer treated with ISBT between September 2018 and August 2021
Definition of PTV as the same as gross tumor volume (GTV)
Removal of the LB during image acquisition of the planning CT to avoid the effects of metal artifacts
Use of the Oncentra Brachy (Elekta, Stockholm, Sweden) TPS for treatment planning
Prescribed dose of 54 Gy/9 fractions/5 days
Use of graphical optimization to improve PTV coverage and reduce the mandibular dose

controls

Positive control: Not specified
Negative control: Not specified

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